National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
10501 to 10525 of 12139 Research Studies DisplayedOsterman MT, Haynes K, Delzell E
Effectiveness and safety of immunomodulators with anti-tumor necrosis factor therapy in Crohn's disease.
This study assessed the effectiveness and safety of immunomodulators with anti-tumor necrosis factor (anti-TNF) therapy in Crohn’s disease (CD). It found that continuation of immunomodulators after “stepping up” to anti-TNF therapy did not improve outcomes but was associated with an increased risk of opportunistic infection.
AHRQ-funded; HS018517.
Citation: Osterman MT, Haynes K, Delzell E .
Effectiveness and safety of immunomodulators with anti-tumor necrosis factor therapy in Crohn's disease.
Clin Gastroenterol Hepatol 2015 Jul;13(7):1293-301.e5; quiz e70, e72. doi: 10.1016/j.cgh.2015.02.017..
Keywords: Patient Safety, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes
Stewart GL, Manges KA, Ward MM
Empowering sustained patient safety: the benefits of combining top-down and bottom-up approaches.
Implementation of TeamSTEPPS for improving patient safety is examined via descriptive qualitative analysis of semistructured interviews with 21 informants at 12 hospitals. Implementation approaches fit 3 strategies: top-down, bottom-up, and combination. The top-down approach failed to develop enough commitment to spread implementation. The bottom-up approach was unable to marshal the resources necessary to spread implementation. Combining top-down and bottom-up, processes best facilitated the implementation and spread of the TeamSTEPPS safety initiative.
AHRQ-funded; HS018396.
Citation: Stewart GL, Manges KA, Ward MM .
Empowering sustained patient safety: the benefits of combining top-down and bottom-up approaches.
J Nurs Care Qual 2015 Jul-Sep;30(3):240-6. doi: 10.1097/ncq.000000000000103.
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Keywords: Patient Safety, TeamSTEPPS, Hospitals, Training
Mody L, Meddings J, Edson BS
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
The authors describe a new initiative based on lessons learned from a recent multimodal Targeted Infection Prevention program in a group of nursing homes as well as a national initiative to prevent catheter-associated urinary tract infections in over 950 acute care hospitals. This initiative will now be implemented in nearly 500 nursing homes through a project funded by AHRQ. It will emphasize professional development in catheter utilization, catheter care and maintenance, and antimicrobial stewardship.
AHRQ-funded; 2902010000251; HS019979; HS019767.
Citation: Mody L, Meddings J, Edson BS .
Enhancing resident safety by preventing healthcare-associated infection: a national initiative to reduce catheter-associated urinary tract infections in nursing homes.
Clin Infect Dis 2015 Jul 1;61(1):86-94. doi: 10.1093/cid/civ236..
Keywords: Nursing Homes, Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI), Patient Safety, Inpatient Care
Bangalore S, Guo Y, Samadashvili Z
Everolimus eluting stents versus coronary artery bypass graft surgery for patients with diabetes mellitus and multivessel disease.
The researchers used data from the New York State registries to assess the comparative effectiveness of coronary artery bypass graft (CABG) when compared with percutaneous intervention (PCI) using everolimus eluting stents (EES) on short- and long-term cardiovascular outcomes. They found that PCI using EES, the latest generation stents, was associated with lower early risk of death and stroke when compared with CABG surgery.
AHRQ-funded; HS023683.
Citation: Bangalore S, Guo Y, Samadashvili Z .
Everolimus eluting stents versus coronary artery bypass graft surgery for patients with diabetes mellitus and multivessel disease.
Circ Cardiovasc Interv 2015 Jul;8(7):e002626. doi: 10.1161/circinterventions.115.002626..
Keywords: Patient-Centered Outcomes Research, Heart Disease and Health, Registries, Surgery
Hicks CW, Hashmi ZG, Hui X
Explaining the paradoxical age-based racial disparities in survival after trauma: The role of the treating facility.
This study sought to determine if differences in outcomes at treating facilities can help explain age-based racial disparities in survival after trauma. For example, among patients older than 65 years, blacks had decreased odds of mortality compared with whites. It found that facility-based differences do not seem to explain this paradoxical age-based racial disparity after trauma observed in the older population.
AHRQ-funded; HS017952.
Citation: Hicks CW, Hashmi ZG, Hui X .
Explaining the paradoxical age-based racial disparities in survival after trauma: The role of the treating facility.
AHRQ-funded; HS017952..
Keywords: Disparities, Comparative Effectiveness, Patient-Centered Outcomes Research, Healthcare Cost and Utilization Project (HCUP)
Padula WV, Valuck RJ, Makic MB
Factors influencing adoption of hospital-acquired pressure ulcer prevention programs in US academic medical centers.
The purpose of this study was to identify wound care nurse perceptions of the primary factors that influenced, the overall reduction of pressure ulcers (PUs). It found that several internal factors influenced evidence-based practice: hospital prevention campaigns; the availability of nursing specialists; and the level of preventive knowledge among hospital staff. External influential factors included financial concerns and data sharing among peer institutions.
AHRQ-funded; HS023710.
Citation: Padula WV, Valuck RJ, Makic MB .
Factors influencing adoption of hospital-acquired pressure ulcer prevention programs in US academic medical centers.
J Wound Ostomy Continence Nurs 2015 Jul-Aug;42(4):327-30. doi: 10.1097/won.0000000000000145..
Keywords: Evidence-Based Practice, Healthcare-Associated Infections (HAIs), Injuries and Wounds, Nursing, Patient Safety, Pressure Ulcers, Prevention
Reistetter TA, Kuo YF, Karmarkar AM
Geographic and facility variation in inpatient stroke rehabilitation: multilevel analysis of functional status.
This study examined geographic and facility variation in cognitive and motor functional outcomes after postacute inpatient rehabilitation in patients with stroke. Its findings suggest that variation in motor and cognitive function at discharge after postacute rehabilitation in patients with stroke is accounted for more by facility than geographic location.
AHRQ-funded; HS022134.
Citation: Reistetter TA, Kuo YF, Karmarkar AM .
Geographic and facility variation in inpatient stroke rehabilitation: multilevel analysis of functional status.
Arch Phys Med Rehabil 2015 Jul;96(7):1248-54. doi: 10.1016/j.apmr.2015.02.020..
Keywords: Stroke, Cardiovascular Conditions, Inpatient Care, Outcomes
Scifres CM, Abebe KZ, Jones KA
Gestational diabetes diagnostic methods (GD2M) pilot randomized trial.
The researchers tested the feasibility of conducting a pragmatic randomized controlled trial (RCT) comparing the International Association of Diabetes in Pregnancy Study Groups (IADPSG) versus Carpenter-Coustan diagnostic criteria for gestational diabetes (GDM), and examined patient and provider views on GDM screening. They found that both pregnant women and providers value GDM screening, and pregnant women can be recruited to a blinded, randomized GDM screening trial with minimal attrition and missing data.
AHRQ-funded; HS019461.
Citation: Scifres CM, Abebe KZ, Jones KA .
Gestational diabetes diagnostic methods (GD2M) pilot randomized trial.
Matern Child Health J 2015 Jul;19(7):1472-80. doi: 10.1007/s10995-014-1651-4..
Keywords: Diabetes, Diagnostic Safety and Quality, Pregnancy, Screening, Women
Sittig DF, Murphy DR, Smith MW
Graphical display of diagnostic test results in electronic health records: a comparison of 8 systems.
In an attempt to understand how well current electronic health records (EHRs) facilitate accurate display and interpretation of clinical laboratory test results, the researchers evaluated the graphical displays of laboratory test results in 8 EHRs using objective criteria for optimal graphs. None of the EHRs met all 11 criteria.
AHRQ-funded; HS022087
Citation: Sittig DF, Murphy DR, Smith MW .
Graphical display of diagnostic test results in electronic health records: a comparison of 8 systems.
J Am Med Inform Assoc. 2015 Jul;22(4):900-4. doi: 10.1093/jamia/ocv013..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Comparative Effectiveness
Skolasky RL, Maggard AM, Li D
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part I: improvement in rehabilitation engagement and functional outcomes.
This study examined whether a brief motivational interviewing-based health behavior change counseling (HBCC) intervention increased patient participation in physical therapy and/or home exercise programs (HEPs), reduced disability, and improved health status after surgery for degenerative lumbar spinal stenosis. It found that HBCC can improve outcomes after spine surgery through improved rehabilitation participation.
AHRQ-funded; HS017990.
Citation: Skolasky RL, Maggard AM, Li D .
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part I: improvement in rehabilitation engagement and functional outcomes.
Arch Phys Med Rehabil 2015 Jul;96(7):1200-7. doi: 10.1016/j.apmr.2015.03.009..
Keywords: Back Health and Pain, Surgery, Patient Adherence/Compliance
Skolasky RL, Maggard AM, Li D
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part II: Patient activation mediates the effects of health behavior change counseling on rehabilitation engagement.
This study sought to determine the effect of health behavior change counseling (HBCC) on patient activation and the influence of patient activation on rehabilitation engagement, and to identify common barriers to engagement among individuals undergoing surgery for degenerative lumbar spinal stenosis. It found that the influence of HBCC on rehabilitation engagement was mediated by patient activation. Despite improvements in patient activation, one-third of patients reported low rehabilitation engagement.
AHRQ-funded; HS017990.
Citation: Skolasky RL, Maggard AM, Li D .
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part II: Patient activation mediates the effects of health behavior change counseling on rehabilitation engagement.
Arch Phys Med Rehabil 2015 Jul;96(7):1208-14. doi: 10.1016/j.apmr.2015.02.031..
Keywords: Back Health and Pain, Surgery, Patient Adherence/Compliance
Silverberg JI
Health care utilization, patient costs, and access to care in US adults with eczema: a population-based study.
This study examined the out-of-pocket costs, health care access and utilization in adult eczema in the United States. It found that adults with eczema had $371 to $489 higher out-of-pocket costs per person-year compared with those without eczema, with higher odds of increased out-of-pocket costs.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Health care utilization, patient costs, and access to care in US adults with eczema: a population-based study.
JAMA Dermatol 2015 Jul;151(7):743-52. doi: 10.1001/jamadermatol.2014.5432.
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Keywords: Access to Care, Healthcare Costs, Healthcare Utilization, Skin Conditions
Murray MT, Pavia M, Jackson O
Health care-associated infection outbreaks in pediatric long-term care facilities.
The researchers performed a retrospective study from January 2010- December 2013 at 3 pediatric long-term care facilities to describe HAI outbreaks and associated infection control interventions. They found that there were 62 outbreaks involving 700 cases in residents and 250 cases in staff. The most common interventions were isolation precautions and education and in-services.
AHRQ-funded; HS021470.
Citation: Murray MT, Pavia M, Jackson O .
Health care-associated infection outbreaks in pediatric long-term care facilities.
Am J Infect Control 2015 Jul;43(7):756-8. doi: 10.1016/j.ajic.2015.03.010..
Keywords: Healthcare-Associated Infections (HAIs), Long-Term Care, Children/Adolescents, Children/Adolescents, Patient Safety
Hinami K, Smith J, Deamant CD
Health perceptions and symptom burden in primary care: measuring health using audio computer-assisted self-interviews.
The purpose of the study was to assess the relationships among somatic symptoms and health perception measures in data collected from the implementation of audio computer-assisted self-interviews. It found physical symptoms, notably lack of energy and pain, to be prevalent and severe in an urban safety-net general medical population. Poor health perception in the patient population was attributable largely to lack of energy and pain.
AHRQ-funded; HS019481.
Citation: Hinami K, Smith J, Deamant CD .
Health perceptions and symptom burden in primary care: measuring health using audio computer-assisted self-interviews.
Qual Life Res 2015 Jul;24(7):1575-83. doi: 10.1007/s11136-014-0884-4..
Keywords: Quality of Life, Primary Care, Health Status, Pain
Albright K, Krantz MJ, Backlund JP
Health promotion text messaging preferences and acceptability among the medically underserved.
Preimplementation focus groups with participants informed the development of text messages that were used in a 6-week pilot program. Postimplementation focus groups and interviews then evaluated the pilot program. The results of the pilot study indicates support among participants for health promotion text messaging embedded into an existing community-based cardiovascular disease risk reduction program.
AHRQ-funded; HS021138.
Citation: Albright K, Krantz MJ, Backlund JP .
Health promotion text messaging preferences and acceptability among the medically underserved.
Health Promot Pract 2015 Jul;16(4):523-32. doi: 10.1177/1524839914566850..
Keywords: Community-Based Practice, Health Promotion, Prevention, Cardiovascular Conditions, Vulnerable Populations
Thienprayoon R, Lee SC, Leonard D
Hospice care for children with cancer: where do these children die?
The primary aim of this report is to describe the location of death in a cohort of children with cancer who enrolled in hospice, the factors significantly associated with death at home, and trends in hospice retention in this cohort. It found that one quarter of those children with cancer who enrolled with an outpatient hospice service returned to the hospital and died in an acute care setting; 5 children died in the ICU.
AHRQ-funded; HS022418.
Citation: Thienprayoon R, Lee SC, Leonard D .
Hospice care for children with cancer: where do these children die?
J Pediatr Hematol Oncol 2015 Jul;37(5):373-7. doi: 10.1097/mph.0000000000000331..
Keywords: Children/Adolescents, Cancer, Patient-Centered Outcomes Research
Holden TR, Smith MA, Bartels CM
Hospice enrollment, local hospice utilization patterns, and rehospitalization in Medicare patients.
The study objective was to examine the association between hospice enrollment, local hospice utilization patterns and 30-day rehospitalization in Medicare patients. It found that area-level hospice utilization is inversely proportional to rehospitalization rates. This relationship is not fully explained by direct hospice enrollment, and may reflect a spillover effect of the benefits of hospice extending to nonenrollees.
AHRQ-funded; HS000083.
Citation: Holden TR, Smith MA, Bartels CM .
Hospice enrollment, local hospice utilization patterns, and rehospitalization in Medicare patients.
J Palliat Med 2015 Jul;18(7):601-12. doi: 10.1089/jpm.2014.0395..
Keywords: Long-Term Care, Palliative Care, Hospital Readmissions, Medicare, Healthcare Utilization
Wang HE, Donnelly JP, Shapiro NI
Hospital variations in severe sepsis mortality.
The authors characterized variations in severe sepsis mortality between hospitals in the United States. They used hospital discharge data from the University HealthSystem Consortium and found variations in institutional severe sepsis observed mortality rates and observed-to-expected mortality ratios.
AHRQ-funded; HS019465; HS013852.
Citation: Wang HE, Donnelly JP, Shapiro NI .
Hospital variations in severe sepsis mortality.
Am J Med Qual 2015 Jul-Aug;30(4):328-36. doi: 10.1177/1062860614534461.
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Keywords: Data, Hospitals, Mortality, Patient-Centered Outcomes Research, Sepsis
Trish EE, Herring BJ
How do health insurer market concentration and bargaining power with hospitals affect health insurance premiums?
The authors examined the relationship between employer-sponsored fully-insured health insurance premiums and the level of concentration in local insurer and hospital markets using the nationally-representative 2006-2011 KFF/HRET Employer Health Benefits Survey. They found that premiums are higher for plans sold in markets with higher levels of concentration relevant to insurer transactions with employers, lower for plans in markets with higher levels of insurer concentration relevant to insurer bargaining with hospitals, and higher for plans in markets with higher levels of hospital market concentration.
AHRQ-funded; HS000046.
Citation: Trish EE, Herring BJ .
How do health insurer market concentration and bargaining power with hospitals affect health insurance premiums?
J Health Econ 2015 Jul;42:104-14. doi: 10.1016/j.jhealeco.2015.03.009.
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Keywords: Health Insurance, Healthcare Costs, Payment, Health Insurance, Hospitals
Dusetzina SB, Ellis S, Freedman RA
How do payers respond to regulatory actions? The case of bevacizumab.
This study examined payer-specific trends in bevacizumab use after the FDA's regulatory actions in granting and revoking an approved indication for metastatic breast cancer. It concluded that although insurers varied in public statements regarding coverage intentions, bevacizumab use declined similarly among all payers, suggesting that provider decision making, rather than payer-specific coverage policies, drove reductions.
AHRQ-funded; HS0189960.
Citation: Dusetzina SB, Ellis S, Freedman RA .
How do payers respond to regulatory actions? The case of bevacizumab.
J Oncol Pract 2015 Jul;11(4):313-8. doi: 10.1200/jop.2015.004218.
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Keywords: Policy, Medication, Health Insurance, Policy
Rivera-Hernandez M, Yamashita T, Kinney JM
Identifying naturally occurring retirement communities: a spatial analysis.
The authors analyzed naturally occurring retirement communities (NORCs) and whether there were spatiotemporal patterns in Ohio between 2000 and 2010. They found that there were different patterns including emerging, disappearing, and enduring NORCs and disproportionate distributions of NORCs across the state between 2000 and 2010. They recommended that locating NORCs could aid governments to create "aging in place" sensitive policies to address issues of independence, social care, health care, volunteerism, and community participation.
AHRQ-funded; HS000011.
Citation: Rivera-Hernandez M, Yamashita T, Kinney JM .
Identifying naturally occurring retirement communities: a spatial analysis.
J Gerontol B Psychol Sci Soc Sci 2015 Jul;70(4):619-27. doi: 10.1093/geronb/gbu077.
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Keywords: Elderly, Home Healthcare
Abrahamson K, DeCrane S, Mueller C
Implementation of a nursing home quality improvement project to reduce resident pain: a qualitative case study.
This article describes the experiences of staff members working within nursing homes that successfully implemented a quality improvement project aimed at reducing resident pain. Findings from the interviews were organized using the Consolidated Framework for Implementation Research. Interdisciplinary communication, supportive leadership, training, and nursing assistant participation facilitated implementation. Increased documentation, resistance to change, and difficulty measuring outcomes were perceived challenges.
AHRQ-funded; HS018464.
Citation: Abrahamson K, DeCrane S, Mueller C .
Implementation of a nursing home quality improvement project to reduce resident pain: a qualitative case study.
J Nurs Care Qual 2015 Jul-Sep;30(3):261-8. doi: 10.1097/ncq.0000000000000099..
Keywords: Nursing Homes, Quality Improvement, Pain, Chronic Conditions
Wang V, Lee SY, Maciejewski ML
Inertia in health care organizations: a case study of peritoneal dialysis services.
The aim of this study was to examine whether strategic and selective factors were associated with the provision of peritoneal dialysis (PD) services in outpatient dialysis facilities in the United States between 1995 and 2003. It found little support for strategic influences and some evidence that selective factors were predictive of dialysis facilities’ PD provision.
AHRQ-funded; HS019479; HS000032.
Citation: Wang V, Lee SY, Maciejewski ML .
Inertia in health care organizations: a case study of peritoneal dialysis services.
Health Care Manage Rev 2015 Jul-Sep;40(3):203-13. doi: 10.1097/hmr.0000000000000024..
Keywords: Kidney Disease and Health, Ambulatory Care and Surgery
Kiyoshi-Teo H, Blegen M
Influence of institutional guidelines on oral hygiene practices in intensive care units.
The purpose of this study was to explore how characteristics of institutional guidelines for oral hygiene influence nurses’ oral hygiene practices and perceptions of that practice. It concluded that the content and dissemination method of institutional guidelines on oral hygiene do influence the oral hygiene practices of critical care nurses.
AHRQ-funded; HS018879.
Citation: Kiyoshi-Teo H, Blegen M .
Influence of institutional guidelines on oral hygiene practices in intensive care units.
Am J Crit Care 2015 Jul;24(4):309-18. doi: 10.4037/ajcc2015920..
Keywords: Intensive Care Unit (ICU), Nursing, Critical Care, Prevention, Guidelines
Rock C, Harris AD, Johnson JK
Infrequent air contamination with Acinetobacter baumannii of air surrounding known colonized or infected patients.
The researchers, by using a validated air sampling method, found Acinetobacter baumannii in the air surrounding only 1 of 12 patients known to be colonized or infected with A. baumannii. Patients’ closed-circuit ventilator status, frequent air exchanges in patient rooms, and short sampling time may have contributed to this low burden.
AHRQ-funded; HS022291.
Citation: Rock C, Harris AD, Johnson JK .
Infrequent air contamination with Acinetobacter baumannii of air surrounding known colonized or infected patients.
Infect Control Hosp Epidemiol 2015 Jul;36(7):830-2. doi: 10.1017/ice.2015.68..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU)